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ABSTRACT

Purpose: Trachoma surveillance is most commonly performed by direct observation, usually by non-ophthalmologists using the World Health Organization (WHO) simplified grading system. However, conjunctival photographs may offer several benefits over direct clinical observation, including the potential for greater inter-rater agreement. This study assesses whether inter-rater agreement of trachoma grading differs when trained graders review conjunctival photographs compared to when they perform conjunctival examinations in the field.

Methods: Three trained trachoma graders each performed an independent examination of the everted right tarsal conjunctiva of 269 children aged 0–9 years, and then reviewed photographs of these same conjunctivae in a random order. For each eye, the grader documented the presence or absence of follicular trachoma (TF) and intense trachomatous inflammation (TI) according to the WHO simplified grading system.

Results: Inter-rater agreement for the grade of TF was significantly higher in the field (kappa coefficient, κ, 0.73, 95% confidence interval, CI 0.67–0.80) than by photographic review (κ?=?0.55, 95% CI 0.49–0.63; difference in κ between field grading and photo grading 0.18, 95% CI 0.09–0.26). When field and photographic grades were each assessed as the consensus grade from the three graders, agreement between in-field and photographic graders was high for TF (κ?=?0.75, 95% CI 0.68–0.84).

Conclusions: In an area with hyperendemic trachoma, inter-rater agreement was lower for photographic assessment of trachoma than for in-field assessment. However, the trachoma grade reached by a consensus of photographic graders agreed well with the grade given by a consensus of in-field graders.  相似文献   
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BackgroundMalaria is the leading vector-borne parasitic disease that is causing high morbidity and mortality worldwide. So far huge efforts to control and eliminate malaria are hindered by the occurrence of asymptomatic carriers that are a potential source of infection. Yet, there is a scarcity of data nationally and in the current study area as well. Therefore, this study was aimed to assess the prevalence of asymptomatic malaria in Northeast Ethiopia.MethodsA community-based cross-sectional study was conducted in 2019 involving a total of 270 study participants recruited via purposive non-probability sampling technique. A structured questionnaire was used to collect data on sociodemographic characteristics, individual and household factors related to asymptomatic malaria. Data were entered in Epi Data 3.1 version and analyzed by using SPSS version 20, and p< 0.05 was considered statistically significant.ResultsThe overall prevalence of asymptomatic malaria was 7.0%, with 3.0%, 5.2%, and 12.0%, respectively by Rapid diagnostic tests (RDT), Microscopy and Polymerase chain reaction (PCR). The majority of infections (73.7%) were identified from index households. Previous malaria history (AOR: 4.030, 95% CI: 1.021–15.903), living with index cases (AOR: 3.880, 95% CI: 1.275–11.806) and family size > 6 members (AOR: 4.820, 95% CI: 1.260–18.437) were significant predictors of asymptomatic malaria.ConclusionReactive case detection had identified considerably higher asymptomatic malaria cases in the community. Therefore, active case investigation should be established in the community by tracking the symptomatic cases at the health facilities.  相似文献   
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This study identified factors that are associated with dental fluorosis among school adolescents in an endemic area using a control design. Data were collected using a directed self-administered questionnaire. Dental fluorosis was confirmed by a dentist. Out of the 472 students who participated in the study, 398 had dental fluorosis and the remaining 74 were free of dental fluorosis. A logistic regression analysis revealed children born in Wonji compared to those born elsewhere [Adjusted OR (95% CI): 5.12 (2.68, 9.75)]; males compared to female [Adjusted OR (95% CI): 2.76 (1.52, 5.00)]; and those who obtained their regular drinking water from pipe distribution compared to those who obtained water from other sources [Adjusted OR (95% CI): 3.5 (1.24, 10.02] were more likely to have dental fluorosis. Students in the age group 13-14 year compared to those in 11-12 year were less likely to have dental fluorosis [Adjusted OR (95% CI): 0.43 (0.25, 0.76)]. The findings indicate that the risk of dental fluorosis is still much higher for the population in Wonji and recommend strengthening appropriate intervention systems at household and community levels.  相似文献   
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OBJECTIVES: The over all aim of the study is to describe the characteristics of patients with burn injuries admitted Yekatit 12 Hospital, Addis Ababa, Ethiopia. METHODS: The design of the study is a cross-sectional type. The data was collected prospectively. All the 121 burn patients admitted to Yekatit Hospital, from July 2001 to September 2002 were included in this study. RESULTS: In the study, the median age was 22 years (range 2 months to 70 years). Among them 64.5% were female and 35.5% were male. Scald was a common cause of burns for young children and flame was a common cause for adults. The frequent mechanism of burn injury for adults was exploding kerosene stove. The average mean total body surface area (TBSA) burnt was 17.1 %. The over all median hospital stay was 44 days. Most of the adults (74.7%) had delayed split thickness grafting. The mortality was 11.6%. This study showed that burn is an important health problem in the country, and it is also burden on the existing poor health care system in our setup. CONCLUSION: Even though this study may not show the true picture of burn patients seen in the country, it can represent the clinical picture of patients seen in most hospitals. To have a clear picture of burns in the population a community based epidemiological study should be done.  相似文献   
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